Individual provider Active NPI

Shannon Cranston, PSYD, LP

  • Clinical Psychologist
  • Flint, MI
National Provider Identifier
1962628404
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014638 Issued in MI
Practice address
1286 S Linden Rd
Suite B
Flint, MI 48532-3457
Phone
(810) 407-7403
Fax
(888) 478-2380
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301014638 MI Primary

Addresses

Primary practice location

1286 S Linden Rd
Suite B
Flint, MI 48532-3457

Mailing address

1286 S Linden Rd
Suite B
Flint, MI 48532-3457
Phone (810) 407-7403

Other identifiers 1

IdentifierTypeStateIssuer
6301014638OtherMILICENSED PSYCHOLOGIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000061 MI Practitioner - Clinical Psychologist 7911149786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shannon Cranston PLLCGroup PAC ID 4486896255, 2 clinicians

Practice addresses (Care Compare)

1286 S Linden Rd B
Center for Psychological Well Being
Flint, MI 48532-3457
Phone (810) 407-7403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Cranston PLLC Clinical CurrentSince Apr 29, 2013 Accepting new patients

Locations

1286 S Linden Rd
Ste B
Flint, MI 48532
Phone (810) 407-7403

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1962628404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 S LINDEN RD",
            "address_2": "SUITE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323457",
            "telephone_number": "810-407-7403",
            "fax_number": "888-478-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 S LINDEN RD",
            "address_2": "SUITE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323457",
            "telephone_number": "810-407-7403",
            "fax_number": "888-478-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANSTON",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "6301014638",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.